Infusion set and injector device for infusion set
An infusion set having an infusion part for insertion into a patient and a connector for connecting the infusion part with a medical device through a tube is provided. The connector is axially displaceable relative to the infusion part. The infusion part includes an adhesive support, a base part with a first set of guiding means and at least two retention devices for locking the connector to the infusion part, a cannula extending from the base part and being in fluid communication with a cavity. The cavity is further adapted to receive a second cannula extending from the connector where the second cannula is in fluid communication with the tube. The infusion set further includes a second set of guiding means that are adapted to fit with the first set of guiding means and at least two arms. The retention devices extend from an upper surface of a main surface of the base part and the arms include means corresponding to the retention members.
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This application claims priority to Danish Patent Application No. PA 200400493, filed Mar. 26, 2004 and U.S. Provisional Application No. 60/556,863, filed Mar. 26, 2004.
TECHNICAL FIELDThe invention relates to an infusion set for an intermittent or continuous administration of a therapeutical substance, such as insulin and an injector device for an infusion set. An infusion set comprises an infusion part with a cannula to penetrate the skin of a person and a connector for connecting the infusion part with a medical device preferably a medical delivery device such as an insulin pump.
An infusion set has in its assembled form a substantially planar rear side and a relatively large width compared to its thickness, thus allowing it to lie flat on the patient's skin and thereby minimizing the discomfort of carrying the infusion set.
The infusion part is placed in the patient for a longer and not specified time period while the connector is supposed to be connected and disconnected from time to time. Hereby it is possible for the patient to disconnect from the medical device, move around and at a later point re-connect to the medical device. Further it is possible to shift between different medical devices using the same infusion part and thereby there is only need for one penetration of the skin which provides less discomfort to the patient.
The injector device according to the present invention is especially directed towards situations where patients wants to or has to insert the infusion part by themselves without the assistance of educated personnel.
BACKGROUNDU.S. Pat. No. 5,522,803 discloses an infusion set having an infusion part and a connector. The infusion part comprises a soft plastic cannula in liquid communication with a cavity for receiving a needle from a connector, two sloping guiding holes and two retention devices; and the connector comprises a cannula, two square guiding pins and two arms with a hooking part for gripping the retention device of the infusion part and operating in the main plane of the infusion part.
A lot of patients e.g. insulin patients have to or may desire to insert an infusion device or to place a subcutaneous sensor or the like themselves. For some persons it is a troublesome process to perform the skin penetration themselves, they therefore need a device which assists them in this process and thereby making the process less problematic.
U.S. Pat. No. 6,572,586B1 discloses an infusion set for administration of a fluid to a subcutaneous layer and include a cannula housing adapted for mounting onto a patient's skin and a needle housing for connection to the cannula housing. The needle housing has a pair of flexible sidewalls and a resilient band connected to the sidewalls. The resilient band is lockably engage able with the cannula housing thereby securing the housings together, and the resilient band is releasable from the cannula housing when pressing the sidewalls toward each other to deform the resilient band. A hollow needle extends out of a main body of the needle housing for delivering fluid to the cannula from a fluid source. The walls of the needle housing extend beyond a distal end of the hollow needle to prevent needle contact with contaminated surfaces an inadvertent injury.
In both of these infusion sets two arms are formed along the sides of the connector part and the movement performed to unrelease the connector from the infusion part is in both cases pressing the two arms together. Compared to these to constructions the present invention is of a more simple form and also the locking mechanism according to the invention allows for the user to actually see when the arms are unlocked, especially if the infusion part and the connector are toned in different colors.
Given that the infusion part is supposed to be connected and especially disconnected several times with the connector it is important that this operation is painless and simple to perform.
The document US 2003/0225373 discloses an insertion device for inserting an infusion part or a sensor into a patient. The device comprises a housing, a coil spring, a safety device and part for angling the insertion into the patient. However the apparatus is relatively complicated to manufacture industrially and further the device has to be loaded manually by the patient by a rather complicated procedure.
WO 03/026728 A1 discloses an injector device comprising a housing, a spring, a slidable bar, a locking mechanism and a needle.
SUMMARY OF THE INVENTIONThe object of the invention is to provide an infusion set with a coupling mechanism which can be connected and separated with as less discomfort to the patient as possible, and which infusion set is also easy for the patient to find out and to operate.
It is also an object of the invention to provide an improved insertion device which is easy to manufacture and which is suitable for being delivered in a loaded form or at least being easier to load. Especially elderly people, who can have some motor problems, need an insertion device which exists in a pre-loaded form.
According to the invention there is provided an infusion set comprising an infusion part for insertion into a patient and a connector for connecting the infusion part with a medical device through a tube. The connector is axially displaceable relative to the infusion part, said infusion part comprising an adhesive support, a base part with a first set of guiding means and at least two retention devices for locking the connector to the infusion part, a cannula extending from said base part and being in fluid communication with a cavity which is optionally covered with a membrane, said cavity being further adapted to receive a second cannula extending from the connector, which second cannula is in fluid communication with the tube, a second set of guiding means adapted to fit with the first set of guiding means and at least two arms where the retention devices are extending from the upper surface of the main surface of the base part and the arms comprise means corresponding to the retention means.
The above described infusion set is easier to disconnect and will seem safer to use for the patient than previously known infusion sets. All that is needed to separate the connector from the infusion part is a slight simultaneous pressure on the two arms of the connector and the user will be able to see how the connection/disconnection between the infusion part and the connector takes place.
With the term cavity is meant the inner lumen of the cannula or the extension of the cannula.
In a preferred embodiment the connector is symmetrical both around the main plain of the connector and around the plane being perpendicular to the main plane and being parallel to the central axis, thus allowing the connector to be connected to the infusion part no matter which of the main sides is facing upwards. This results in an easier operation of the infusion set.
The arms of the connector can appropriately be provided with gripping means for getting a better grip of the connector. Examples of such gripping means could be but are not limited to rims, grooves, recesses, and a roughened surface optionally of another material than the connector itself, preferably recesses are used. This results in a safer and more comforting operation of the infusion set since the risk that the fingers slip during handling resulting in unintended movements of the infusion part and the cannula is reduced.
In one embodiment of the invention the connector has a reduced material content e.g. in the form of at least one groove, preferably at least two grooves, placed where the arms are connected to the central part of the connector comprising the second set of guiding means (8), thus allowing the arms of the connector to move perpendicular to the base part while the second set of guiding means are stationary. This makes it possible to disconnect the connector from the infusion part by lifting the arms instead of pressing them towards each other. Hereby it is achieved that connection/disconnection can be performed in a manner which at the same time reduces the stresses in the material during the operation, eases the operation of the locking mechanism and reduces the patient's unpleasantness during the connection/release of the connector.
In another embodiment retention devices are positioned on a particularly flexible part of the base part. The flexible part can be provided by choosing an appropriate material for the base part or by providing very thin parts of material between the retention parts and the center of the base part, but preferably the base part of the infusion part has at least two cuttings forming at least two flaps. The formed flexible parts are able to in an elastic manner to move out of the main plane of the infusion part. Hereby the same advantages during connection/release as described above are obtained.
In a preferred embodiment the cannula of the infusion part penetrates the adhesive support, thus stabilizing the position of the infusion part relative to the point of skin penetration to an even greater extend. Further this minimizes the risk that the cannula is accidently withdrawn from the patient.
In a preferred embodiment the adhesive support is a plaster.
In a preferred embodiment the infusion part and the connector are made from two different plastics materials, such as two different types of polypropylene.
In a preferred embodiment there is a visual difference in the toning of the connector and the base part of the infusion part. Hereby it is achieved that it is easier for the patient to see the separation line between the two units resulting in an easier operation of the locking mechanism.
In a preferred embodiment the retention devices are in form of at least two steps placed on either the infusion part or the connector and a matching carving in the other part. Preferably the step has a side with a triangular shape thus forming the step as a sloping hill. Preferably the retention devices are placed on the infusion part and the matching carvings are placed in the connector's arms.
In a preferred embodiment the tube is a flexible plastics material which preferably is connected with the rest of the connector by means of glue.
Preferably the medical delivery device is a drug delivery device such as an insulin delivery device e.g. in the form of an insulin pump.
The cannula of the connector can be a hard cannula, preferably a metal cannula such as a steel cannula. Also the cannula of the connector can be made of a plastics material and/or being blunt.
In a preferred embodiment the cannula is a soft cannula preferably a soft cannula made of a plastics material. Preferred plastics materials for the soft cannula are materials which are sufficiently flexible to bend, when the patient moves and sufficiently rigid to avoid kinking, closing off the drug supply. Further the material must be compatible with medical use i.e. irritation of the skin must be kept at a minimum, being non-toxic it must not decompose in the body, etc. Thermoplastic elastomers (TPE) are a type of material which fulfils these requirements. Examples of such useful elastomers are: polyester ethers, ECDEL, styrene based TPE, olefin based TPE, urethane based TPE, ester based TPE, amid based TPE, polyolefins and silicone rubbers. In a preferred embodiment the material is selected from the group consisting of polypropylene, C-FLEX™, mixtures of C-FLEX™ and polypropylene, LUPOLEN™ 1840H, LUPOLEN™ 3020D, PELLETHANE™ 2363-75D, PELLETHANE™ 2363-55D, TECOTHANE™ and CARBOTHANE™.
In a preferred embodiment the infusion part and the connector are made of polypropylene.
Given that the infusion part is supposed to be connected and especially disconnected several times with the connector it is important that the cannula of the connector is guided safely into the cavity of the infusion part and that the cannula in the disconnected situation is protected as much as possible. It is therefore a further object of the invention to provide an infusion set with an improved guiding mechanism and with an improved protection of the connector cannula.
In a preferred embodiment the connector cannula is extending from the central part of the connector and being placed in a withdrawn position relative to the front of the central part and at least one of the first set of guiding means comprises at least two stabilizing fins.
The above described invention provides an infusion set with an improved protection of the cannula of the connector thus allowing the connector to be connected and disconnected from the infusion part more times than in the previously known infusion sets.
A lot of patients e.g. insulin patients have to or may desire to insert an infusion device or to place a subcutaneous sensor or the like themselves. For some persons it is a troublesome process to perform the skin penetration themselves, they therefore need a device which assists them in this process thereby making the process less problematic.
The advantage in essentially vertical insertion is that it is easier to control the dept of the needle penetration and thereby the dept of the cannula. This is important in self-insertion of the infusion part.
According to the invention an injector device is provided for the subcutaneous introduction of a cannula of an infusion part into the skin of a patient. The injector device comprises a housing, a back and longitudinally extending guiding means, a member which is longitudinally slidable within the housing, an insertion needle for insertion in the cavity of said cannula, a spring located between the back of the housing and the longitudinally slidable member, locking means for maintaining the spring in a compressed state and release means for disengaging the locking means characterized in that the device further comprises a pivoting member which can be swung from a position in which the pivoting member allows for insertion of the needle into a position in which the pivoting member embraces the needle.
The insertion device according to this invention is easy to handle in a safe way before, during and after use, even if the user has reduced dexterity in the hands. Also the user can choose an essentially vertical insertion which makes it easier to control the dept of the needle penetration and thereby the insertion dept of the cannula. This is important in self-insertion of the infusion part. Besides the injector is of a very simple construction which makes it possible to reduce costs of production.
The insertion needle can during insertion be unreleasably attached to the slidable member, unreleasably attached to the infusion part thereby being the cannula or the insertion needle can be a separate unit which the user removes after insertion.
In a preferred embodiment the pivoting member is fastened to the slidable member. This makes production of the unit simpler, and also the pivoting member will need to be shorter than if the pivoting member was fastened to the housing. If the pivoting member is fastened to the slidable member, the position where the pivoting member allows for insertion of the needle is preferably in an angle v where v≈45° or larger in order for the pivoting member to be bend backwards when touching the user, preferably v≈90° or larger in order for the pivoting member not to hit the user during insertion. The angle v is the angle between the central axis of the injection device which is parallel to the insertion needle, and the pivoting member.
In a preferred embodiment the insertion device has means for temporarily fixing the pivoting member in an essentially right angle relative to the housing thus stabilizing the insertion device in an essentially vertical position relative to the skin to be penetrated prior to penetration. This is particularly relevant for patients with motor problems since they can have problems to control the insertion angle.
Preferably the housing has means for getting a better grip of the injector device. Examples of such means could be but are not limited to rims, grooves, recesses, a roughened surface optionally of another material than the housing itself, preferably recesses are used
There will be different possibilities for placing the pivoting member in the position where it embraces the needle but in a preferred embodiment the pivoting member embraces the needle when the slidable member is in a forward position and the spring is in a released state. Often when using injection devices in connection with insertion of infusion sets the user is supposed to bring the insertion needle back into the housing in order to protect the surroundings from the used insertion needle. This means the users has to work against the spring force, which was pushing the needle forward during insertion, and at the same time the user has to avoid the used needle, when bringing it back into the housing. This can be quite difficult for a user which might have reduced dexterity of the hands and fingers. According to the present invention it will be quite easy for the user to secure the insertion needle as turning the relatively large pivoting member does not call for the use of strength.
In one embodiment the insertion needle is destroyed and secured as the pivoting member is placed in a final position embracing the needle. This will make it safe to dispose of the used insertion device with ordinary garbage.
In one embodiment the pivoting arms are also the locking means and it has a tab functioning as disengaging means.
In another embodiment there is separate locking means and disengaging means. Preferably the pivoting member then still have a tab for securing the arm in a position parallel to the axis of the housing until it is desired to swing the pivoting member to the position in which it embraces the needle.
Preferably the pivoting member embraces the needle in a first position being parallel to the main axis of the injector device then it is swung into a second position being essentially orthogonal to said main axis and then finally swung into a position in which it embraces the needle.
In a preferred embodiment the pivoting member is swung from the position essentially orthogonal to said main axis, 180 degrees to another position embracing the needle and being secured in this position said position also being essentially orthogonal to the main axis. Optionally the needle is destroyed in the process and secured in the pivoting member.
In another preferred embodiment the infusion part to be inserted is provided with an adhesive support unreleasably fastened to the infusion part and having an adhesive surface, which adhesive surface is provided with a release liner.
In this embodiment the pivoting member can have fixing means for releasably fastening a part of the adhesive support to the pivoting member. This construction assures that the adhesive support is folded in an appropriate way during insertion, which results in that the adhesive support will turn a part of the adhesive surface towards the user's skin, when the infusion part is inserted.
In another preferred embodiment the release liner of the adhesive support can also have one or more projecting parts. Describing parts as projecting from the release liner means that the parts are not necessarily in contact with the adhesive surface of the adhesive support, the projecting part or parts extend beyond the part of the release liner being in protecting contact with the adhesive surface. One of the projecting parts can be fastened unreleasably to the housing in order to at least partly have the release liner removed from the adhesive support during insertion of the needle. The total removal of the release liner will take place after insertion of the needle when the injector device is taken away for disposal and the release liner will—as it is still attached to the injection device—be removed and disposed off together with the used injector device.
In a more preferred embodiment the release liner comprises at least two separate pieces, and each piece has at least one projecting part. This makes it possible to remove the release liner automatically during insertion without the release liner coming into conflict with the insertion needle.
Preferably the projecting part of the first piece of release liner is attached to the pivoting member during insertion and the projecting part of the second piece of release liner is attached to the housing during insertion. This embodiment makes it easier for the user to remove the release liner during/after insertion and at the same time the adhesive surface of the adhesive support is completely protected before insertion.
In a preferred embodiment of the invention the pivoting member of the injector device further has means for temporarily fixing the adhesive support of the infusion part. Hereby it is achieved that the adhesive support does not fold in an unsuitable manner during insertion of the infusion part.
Preferably the injector device comprises means for stopping the slidable member in its most forward position preferably in form of a stopping tab.
In the following the invention will be described in further details with reference to the figures.
Whether the infusion set is intended to be inserted manually or by an injector the infusion part (0B) and the connector (0A) are delivered to the user as two separate units in sterile packages. When inserted manually the infusion part (0B) will at delivery be combined with a needle unit with the same locking and guiding means (8) as the connector. The needle unit is provided with an insertion needle extending from the central front which insertion needle at delivery extends through and beyond the end of the cannula (5). The needle unit's only function will be to penetrate the user's skin where after the needle unit is removed and replaced with the connector (0A) leaving the cannula (5) subcutaneous.
The connector (0A) can be connected to a luer coupling member through the tube (7). Through the luer coupling it is possible to administer a suitable therapeutical substance, such as insulin from a pump. The connector can also be a sort of closing part with a suitable entrance for an inserting needle of a syringe. Such a closing part can stay in position for up till three days while the user can have medication, e.g. insulin injected through the entrance in order to reduce trauma to the skin caused by repeated penetration of the skin.
It is important for the user that it is easy to change i.e. to engage and to disengage the infusion part (0B) and the connector (0A) even when the user has reduced dexterity. The present invention complies with this purpose as the movement used to unlock the infusion part (0B) from the connector (0A) is pressing the connector between the first finger and the thumb which is simple and easily performed movement. Also the oppositely directed forces from respectively the first finger and the thumb pushing toward each other, are not only used to unlock the device but is also used when pulling the connector away from the infusion part (0B). In order to make it easier to disengage the connector (0A) the arms (9) can be made very flexible, either by choosing a soft and flexible material or by making the fastening of the arms (9) to the central part more or less rigid e.g. by varying the size of the grooves (14) on the shoulder of the connector (0A).
Although the arms (9) are very flexible the danger of accidently pulling the connector away from the infusion part when positioned on the skin of the user is quite small as the device has to be exposed to a simultaneous pressure from both sides.
Another advantage of the invention according to the present invention is that only a very small amount of material need to be used when producing the infusion part. The infusion part (0B) can be reduced to:
-
- a slim central part comprising the cannula (5), the cavity (3) and guiding means (13),
- a shoulder part (2a) connected to the central part and protecting the ends of the movable arms (9) of the connector when the connector is engaged with the infusion part, and
- a base part (2) which has been reduced to two arms connected to the central part which arms are provided with the retention means (4).
Centrally positioned release means (39) is shown on one of the main faces of the injector device. The advantage of a one button release mechanism is that the risk of a slanting injection is reduced.
In
In
In
In
In
The distance between (I) the side of the retention device (4) closest to the central part of the infusion part (0B) and (II) the central part of the infusion part (0B) defines how far it is possible to move the two arms (9) of the connector in the plane parallel to the base part (2). It is necessary for the corresponding means (10) in the arms (9) of the connector (0A) to be of less width than the distance between (I) and (II). In a preferred embodiment it would also be possible to free the connector (0A) from the infusion part (0B) by moving the arms (9) in a vertical direction away from the base part (2). If this should be possible the arms (9) of the connector need to be adequately flexible where the arms (9) are fixed to the central part of the connector. This can be done either by reducing the thickness of the arms (9) in at least on direction in this area until the desired flexibility is achieved or by choosing to construct the connector part (0A) of a material with a suitable flexibility.
In this embodiment the release liner (41, 42) of the adhesive support (1) is divided into to separated pieces. The first piece (41) is protecting the part of the adhesive support (1) in front of the cannula (5), and the second piece (42) is protecting the part of the adhesive support being behind the cannula (5) and under the infusion part. During insertion the two pieces are separated whereby the part of the adhesive in front of the cannula is bent up and the adhesive side of the adhesive support (1) is exposed around the cannula. The first piece (41) is either pulled back by the user or is attached to one side of the injector device; the second piece (42) is attached to the opposite side of the injector device.
In
When the infusion set is delivered to the patient together with the injector device, the infusion part (0B) and the connector (0A) are packed separately and under sterile conditions, and the infusion part (0B) is placed in the injector device (
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Finally after withdrawal of the insertion needle which in this embodiment is attached to the slidable member (32) in the injector device, it is shown in
Claims
1. An assembly for the subcutaneous introduction of a cannula of an infusion part into a patient, the assembly comprising:
- an infusion part comprising:
- an adhesive support;
- a base part including at least two retention devices configured to releasably lock a connector to the infusion part, the retention devices extending from an upper surface of a main surface of the base part; and
- a cannula extending from the base part and being in fluid connection with a cavity of the infusion part, the cavity being adapted to receive a second cannula extending from the connector and through which a therapeutical substance is administrable; and
- an injector device comprising an insertion needle configured to releasably receive the infusion part, the insertion needle extending at least partially through at least a portion of the cannula to insert the cannula into the skin of the patient;
- wherein at least a portion of the adhesive support is connected to a portion of the injector device; and a pivoting member connected to the injector device and pivotable from an insertion position into a protection position, the insertion position configured to allow insertion of the needle into the patient and the protection position configured to protect the needle wherein the pivoting member embraces the needle.
2. The assembly of claim 1, wherein the retention devices are positioned at flexible parts of the base part.
3. The assembly of claim 2, wherein the base part comprises at least two flaps on which the retention devices are positioned.
4. The assembly of claim 1, wherein the cannula passes through the adhesive support.
5. The assembly of claim 1, wherein the retention devices each comprise a step.
6. The assembly of claim 1, wherein the retention devices have a triangular shape.
7. The assembly of claim 1, wherein the cannula comprises thermoplastic elastomers (TPE).
8. The assembly of claim 7, wherein the thermoplastic elastomer is selected from the group consisting of polyester ethers, ECDEL, styrene based TPE, olefin based TPE, urethane based TPE, ester based TPE, amid based TPE, polyolefins and silicone rubbers.
9. The assembly of claim 1, wherein the infusion part comprises polypropylene.
10. The assembly of claim 1, wherein a projecting part of a release liner of the adhesive support is fastened to the injector device.
11. The assembly of claim 1, further comprising a release liner of the adhesive support, the release liner comprising at least two separate pieces.
12. The assembly of claim 11, wherein a portion of each piece of the release liner is attached to the injector device during insertion.
13. An assembly for the subcutaneous introduction of a cannula of an infusion part into a patient, the assembly comprising:
- an infusion part comprising: an adhesive support; a base part including at least two retention devices configured to releasably lock a connector to the infusion part, the retention devices extending from an upper surface of a main surface of the base part; and a cannula extending from the base part and being in fluid connection with a cavity of the infusion part; and
- an injector device comprising: a housing comprising a longitudinally extending guide; a slidable member adapted to longitudinally slide relative to the housing; a needle connected to the slidable member, the needle configured for insertion at least partially through the cannula to insert the cannula into the skin of the patient, a spring located between a back portion of the housing and the longitudinally slidable member; and a pivoting member connected to the injector device and pivotable from an insertion position into a protection position, the insertion position configured to allow insertion of the needle into the patient and the protection position configured to protect the needle wherein the pivoting member embraces the needle.
14. The assembly of claim 13, wherein the pivoting member is fastened to the slidable member.
15. The assembly of claim 14, wherein the insertion position of the pivoting member is an insertion angle between about 45° and about 180°, the insertion angle measured in relation to a central axis of the needle.
16. The assembly of claim 14, wherein the insertion position of the pivoting member is an insertion angle between about 80° and about 180°, the insertion angle measured in relation to a central axis of the needle.
17. The assembly of claim 14, wherein the insertion position of the pivoting member is an insertion angle between about 90°, the insertion angle measured in relation to a central axis of the needle.
18. The assembly of claim 13, wherein the pivoting member is placed substantially parallel to the housing when the pivoting member is in the position where the pivoting member embraces the needle.
19. The assembly of claim 13, wherein the pivoting member is placed in an embracing angle with respect to the housing between about 0° and about 180° when the pivoting member is in the position where the pivoting member embraces the needle.
20. The assembly of claim 13, wherein the pivoting member is placed in an embracing angle with respect to the housing between about 90° and about 180° when the pivoting member is in the position where the pivoting member embraces the needle.
21. The assembly of claims 13, wherein the pivoting member can embrace the needle when the slidable member is in a forward position and the spring is in a released state.
22. The assembly of claim 13, wherein the needle is destroyed and secured in the pivoting member in the protection position.
23. The assembly of claim 13, wherein the assembly further comprises locking means for maintaining the pivoting member in the protection position.
24. The assembly of claim 13, the pivoting member has fixing means for releasably fastening a part of the adhesive support to the pivoting member.
25. The assembly of claim 13, wherein a projecting part of a release liner of the adhesive support is unreleasably fastened to the housing.
26. The assembly of claim 13, further comprising a release liner of the adhesive support, the release liner comprising at least two separate pieces.
27. The assembly of claim 26, wherein each piece of the release liner is attached to the pivoting member during insertion and the projecting part of the second piece of the release liner is attached to the housing during insertion.
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Type: Grant
Filed: Mar 21, 2005
Date of Patent: Jan 19, 2010
Patent Publication Number: 20050215979
Assignee: Unomedical A/S (Birkeroed)
Inventors: Grete Kornerup (Vipperød), Lasse Wesseltoft Mogensen (Søborg), Magnus Walter Göransson (Malmö )
Primary Examiner: Nicholas D Lucchesi
Assistant Examiner: Quynh-Nhu H Vu
Attorney: Brinks Hofer Gilson & Lione
Application Number: 11/084,893
International Classification: A61M 25/16 (20060101);